UPDATE: On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962)” which includes a delay in the 21+% Medicare fee cut until November 30, 2010. CMS will have the MACs start processing new claims with dates of service of June 1, 2010 and later at the 2009 fee schedule plus a 2.2% increase. The MACs will also have to reprocess the claims already paid for dates of service June 1, 2010 and later that were processed with 2010 fee schedule and that big fat cut.
Note: On June 16, 2010 the Senate failed to pass a proposal that would increase the Medicare reimbursement for physicians by 2.2% for the balance of calendar year 2010 and by 1% for calendar year 2011. Senate leadership is now working on a plan to extend the freeze until year-end. The following statement was released by the state medical societies of all 50 states and the District of Columbia, as well as 41 specialty physician organizations.
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Statement of the State and Specialty Medical Societies on the Medicare Physician Payment Crisis
Failure by Congress to fulfill its responsibilities is undermining patient care in America. Three times this year, Congress has missed a deadline for dealing with Medicare’s sustainable growth rate (SGR) formula, raising the specter of a 21 percent payment cut for physician services. The disruption and uncertainty for patients and physicians has made Medicare an unreliable program.
If Congress does not act this week, Medicare physician payments will be cut 21 percent. These cuts will also extend to the TRICARE program which serves military families, as well as some Medicaid programs, workers compensation programs and private insurance plans. The ripple effect of the 21 percent Medicare cut will be devastating to physician practices.
Congressional mismanagement of the Medicare program will force more physicians to stop accepting new Medicare and TRICARE patients; lay-off staff; and defer investment in new medical equipment, health information technology, and other innovations that improve patient care.
Patients and physicians should not become collateral damage in a Congressional stalemate on budgetary matters. We expect our elected officials to resolve the budget issues without punishing physicians, seniors and military families.
Past actions by Congress created the current budgetary challenge. Further, since 2003, Congress has compounded this problem by employing budget gimmicks that defer immediate cuts by stipulating deeper cuts in future years.
Democrats and Republicans agree that the flawed Medicare formula that is responsible for pending cuts should be repealed. The annual SGR battle diverts attention from more productive delivery and payment reform initiatives. We must move to a payment system that fosters innovation and rewards physician efforts to lower the rate of growth in Medicare spending across the existing silos in the program.
Medicare must adequately cover the cost of care and close an existing 20 percent gap as measured by the government’s own conservative measure of annual increases in medical practice costs.
We must also allow seniors who wish to contract directly for their care with a physician of their choice to do so without foregoing the Medicare benefits for which they paid during their working years. Medicare benefits were earned by and belong to Medicare beneficiaries. They must be allowed to assign these benefits as they see fit.
Playing brinksmanship with the health care of seniors and military families is inexcusable and represents a dereliction of duty. We urge Congress to honor its obligation to provide access to quality care to America’s seniors and military families by taking action to fix the Medicare physician formula problem now!
American Academy of Dermatology American Academy of Facial Plastic & Reconstructive Surgery American Academy of Family Physicians American Academy of Hospice & Palliative Medicine American Academy of Neurology American Academy of Ophthalmology American Academy of Pain Medicine American Academy of Pediatrics American Academy of Physical Medicine & Rehabilitation American Academy of Sleep Medicine American Association for Hand Surgery American Association of Clinical Endocrinologist American Association of Clinical Urologist American Association of Neurological Surgeons American Association of Neuromuscular & Electrodiagnostic Medicine American Association of Public Health Physicians American College of Cardiology American College of Emergency Physicians America College of Gastroenterology American College of Obstetricians & Gynecologists American College of Occupational & Environmental Medicine American College of Rheumatology American College of Surgeons American Gastroenterological Association American Institute of Ultrasound in Medicine American Medical Association American Orthopaedic Foot & Ankle Society American Society for Clinical Pathology American Society for Reproductive Medicine American Society for Surgery of the Hand American Society of Addiction Medicine American Society of Cataract & Refractive Surgery American Society of Cytopathology American Society of Ophthalmic Plastic & Reconstructive Surgery College of American Pathologists Congress of Neurological Surgeons Heart Rhythm Society North American Spine Society Renal Physicians Association Society of American Gastrointestinal Endoscopic Surgeons Society of Nuclear Medicine
Medical Association of the State of Alabama Alaska State Medical Association Arizona Medical Association Arkansas Medical Society California Medical Association Colorado Medical Society Connecticut State Medical Society Medical Society of Delaware Medical Society of the District of Columbia Florida Medical Association, Inc. Medical Association of Georgia Hawaii Medical Association Idaho Medical Association Illinois State Medical Society Indiana State Medical Association Iowa Medical Society Kansas Medical Society Kentucky Medical Association Louisiana State Medical Society Maine Medical Association MedChi, The Maryland State Medical Society Massachusetts Medical Society Michigan State Medical Society Minnesota Medical Association Mississippi State Medical Association Missouri State Medical Association Montana Medical Association Nebraska Medical Association Nevada State Medical Association New Hampshire Medical Society Medical Society of New Jersey New Mexico Medical Society Medical Society of the State of New York North Carolina Medical Society North Dakota Medical Association Ohio State Medical Association Oklahoma State Medical Association Oregon Medical Association Pennsylvania Medical Society Rhode Island Medical Society South Carolina Medical Association South Dakota State Medical Association Tennessee Medical Association Texas Medical Association Utah Medical Association Vermont Medical Society Medical Society of Virginia Washington State Medical Association West Virginia State Medical Association Wisconsin Medical Society Wyoming Medical Society
UPDATE: On June 24, 2010 the House and Senate passed legislation to further delay the Medicare cuts until November 30, 2010. More here.
Excerpt From Today’s CMS Announcement (with my bolding):
The Centers for Medicare & Medicaid Services (CMS) is hopeful that Congressional action will be taken within the next several days to avert the negative update.
Given the possibility of Congressional action in the very near future, CMS is now directing its contractors to continue holding June 1 and later claims through Thursday, June 17, lifting the hold on Friday, June 18.
This action will facilitate accurate claims processing at the outset and minimize the need for claims reprocessing if Congressional action changes the negative update. It also should minimize the provider and beneficiary burdens and costs associated with reprocessing claims.
We understand that the delayed processing of Medicare claims may present cash flow problems for some Medicare providers. However, we expect that the delay, if any, beyond the normal processing period will be only a few days. Be on the alert for more information regarding the 2010 Medicare Physician Fee Schedule Update.